Molina Urges Reforms in Hiring County Nurses

Los Angeles County Supervisor Gloria Molina on Tuesday proposed reforms to boost recruitment and retention of nurses in response to a Times report on potentially lethal treatment delays at Los Angeles County-USC Medical Center.

Molina also asked county health staff to investigate the deaths of patients described in The Times’ articles and report to supervisors privately in 30 days. County officials say the details of the cases are protected by rules governing patient confidentiality.

County-USC doctors say three patients died in the last 10 months after prolonged waits for emergency dialysis.

The problem was that dialysis nurses were not readily available on nights and Sundays. In January, after the third death, dialysis nurses were put on call around the clock. But patients still experience long waits for other services, partly because of a severe nursing shortage, doctors say.

Molina is seeking to speed up critical care to patients by attracting and retaining more nurses. Among her proposals are to pay relocation costs for new nurses, to pay tuition for nurses who seek to expand their skills and to streamline the application process.

The union that represents county nurses called Molina’s action “a step in the right direction” but said supervisors could do more to swiftly address the nursing crisis. Kathy Ochoa, an analyst with the Service Employees International Union, Local 660, said supervisors have not yet tapped $40 million in federal money, part of which could be used to train new dialysis nurses.

Molina, however, said the hospital’s problems are not only financial. “It isn’t just money. It’s management.”

She said she hopes that a new management team taking the reins next month will make the hospital more responsible in treating patients. Hospital director Roberto Rodriguez, who resigned in March, will depart at the end of this week.

Molina, whose district includes the hospital, said she was concerned that doctors at County-USC who complained about dialysis and other delays were apparently not heeded by administrators.

“The doctors are very frustrated that they don’t have any connection with administration,” she said.

Molina inspected the hospital earlier this year in response to complaints from medical staff. She said she found the hospital’s nursing recruitment office in disarray.

Hospital officials acknowledge that at that time it took six weeks to hire nurses amid a nationwide nursing shortage. They say they have since shaved that time significantly.

Still, Molina said, she remains baffled at some of the current recruitment procedures. For example, nurses interested in applying for jobs at more than one of the county’s six hospitals must go to every separate location.

A lack of nurses at County-USC has caused operating rooms to close and beds to lie empty for lack of staff. That keeps patients stalled in the emergency room, where they do not always get the full attention they need.

Dr. David Altman, the new medical director of County-USC, said Molina’s recommendations, which are to be considered at next week’s board meeting, address a core problem: unwieldy hiring requirements.

“We tend to be too bureaucratic in these things,” he said.